When it comes to cosmetic injectables, Brentwood patients usually know what they want. We make sure they get answers to any questions that might pop up.

Over 3 years ago, I ran into someone’s shoulder while playing soccer and my nose is now crooked and has made it more difficult to breath. Can this be fixed without surgery?

Non Surgical Rhinoplasty is a procedure that I popularized 13 years ago and still perform on a daily basis. It works really well for mild to moderate crooked noses. Pictures of your nose would help determine whether you would be a good candidate, but an in person consultation is the only way to know for sure. I like to use either Voluma or Radiesse for the procedure. It takes 5 to 15 minutes to perform, carries minimal risks if any and causes minimal pain. Results are visible immediately afterwards and last for up to a year and a half. There are also permanent option available, using Bellafill, but I recommend that people try the temporary fillers first. The problem is that you are reporting trouble breathing through your nose. Non Surgical Rhinoplasty really can’t help with breathing difficulties. I often recommend trying steroid nasal spray as an easy method of improving nasal breathing before you go for surgery, but again, evaluation of what’s going on inside your nose is necessary.

Hope that helps!

How to fix protruding mouth? My mouth protrudes quite a bit, mostly the upper lip. I have a very mild overbite and no overjet.

Thank you for your inquiry. Looking at your profile I would recommend having a Non-Surgical Chin Augmentation where I would inject a small amount of filler (usually Voluma or Radiesse) into precise points of your chin area, building up the chin and bringing your profile into balance. Doing this will make your upper lip look less projected. Results of this non-surgical procedure are precise because the injector can expand only the areas that are absolutely necessary for the optimal cosmetic result without the pain, risk, and recovery time involved with surgical chin implants. You are a good candidate for filler injection into the chin because you do not need a lot of projection. Fillers like Juvederm can also be added it the bottom lip to add symmetry between the bottom and top lip.

I’m not happy with the shape of my lips. What is the best way or the safe option, to change the shape of my lips? Do I need a surgery? What is the cost? And where should I go to fix it?

Lip Augmentation is a great way to enhance or correct your own lip shape while keeping a natural appearance. This can be achieved through filler injections without any need for surgery. The most preferred filler for the lips is Juvederm Ultra, which is a hyaluronic acid (a water binder found naturally in the body). Juvederm Ultra lasts anywhere from 6 to 12 months. The most common side effects for Lip Augmentations are bruising and mild swelling. We recommend avoiding blood thinners (aspirin, ibuprofen, alcohol, fish oil etc.) for at least seven days before the procedure to help minimize your change of bruising. If pain is a concern, a topical numbing cream can be administered prior to injection to help manage any discomfort. Prices for Lip Augmentation vary between offices but a typical range can be anywhere from $400-$800 depending how much filler needs to be used. It is always recommended to do your research on providers in your area specializing in this treatment to make sure your in the best hands possible.

I was wondering if there was any way to get rid of the small bump on my nose without plastic surgery? There is a bump on the bridge of my nose and it’s fairly small.

Non Surgical Rhinoplasty is a procedure that I popularized 13 years ago and still perform on a daily basis. I see excellent results camouflaging small bumps such as the one that you have. All it takes is a small amount of filler above and below the bump and your nose will be straight on profile. There are several options of fillers. For a temporary effect of about 1 to 1.5 years I like to use Voluma. The result is smooth and natural looking and the filler is reversible with an enzyme injection if you don’t like the result (almost never happens). There is a longer lasting filler called Bellafill that I use with patients who have had the temporary procedure. Bellafill lasts for many years and in some patients is actually permanent. Whether temporary or permanent, Non Surgical Rhinoplasty takes 5 to 15 minutes to perform, involves minimal pain, minimal risk, no downtime or swelling and you can see the results immediately after the procedure. I think that it would absolutely be a great alternative to surgery in your case.

Hope that helps!

Does Kybella cause sagging skin? If kibella is used to destroy submental fat, what happens to the skin? After loss of submental volume, does the skin begin to sag? If it doesn’t, what makes Kybella tighten the skin after the fat dissolves? Thanks

No. Kybella is an excellent injectable for reduction of submental fat. It destroys fat cells and as it does so, it creates an inflammatory response. That inflammation causes the area to swell for several days, which is inconvenient, but it also causes the skin in that area to tighten up. How much fat destruction and how much skin retraction happens with each Kybella treatment will depend on the individual patient, but I have seen great results in my clinic. The key to getting retraction is the presence of some fat. If the area under the chin is all skin, then I would hesitate on recommending Kybella. If you are thinking about Kybella treatment, you have to know that it takes more than one session. Some patients are done after two but some need three to get the desired result. Treatments are spaced about 6 weeks apart.

Hope that helps!

Would lip injections be suitable to make upper lip project further out in profile view? When facing head on my lips appear relatively full, but from the side my top lip is very flat. Is it possible to make my lips more symmetrical without making them wider? My dentist and orthodontist tell me I do not have an under bite.

Hi! The answer is that fillers will certainly help. I like to use Juvederm for lip augmentation and I have had really great, natrual looking results with lips such as yours augmenting essentially just the border of the upper lip. This should project your upper lip out so that it is in line with the lower. You should not need much filler to get this done – probably a half syringe will do. Lip augmentation is a bit of an art form – making them look perfectly natural can be tricky. Make sure that you find an injector who is very experienced in lip augmentation.

Hope that helps!

I had 9 vitrase injections with 3 different doctors. I cannot get rid of it 25% after 9 rounds (one full strngth). Would a detailed CT scan or MRI help doctors locate where the Voluma is and kill it once and for all? I have been miserable and depressed. On my chin, I have this rubbery blob and it also made my face asymmetrical and swell up. 2 ml Voluma, 9 rounds of Vitrase. The doctor does not remember where injected or it migrated. MRI/detailed CT scan to find it?

I’m sorry, it sounds like you are going through a frustrating experience. I have managed a few cases where Voluma results in swelling and even intermittent, recurrent infection. This kind of thing might be happening with you. It is not easy to get the filler to dissolve in these cases. My suggestion would be to go to the most experienced Voluma injector you can find and see what they can do. Treatment may involve antibiotics and high doses of enzyme – much higher doses than usually employed to dissolve these kinds of fillers. Good luck and I’m happy to chat with you in detail if you’d like to call for advice.

Hope that helps!

What would cause the severe bruising, lumps and bumps on my lips? First time getting lip injections on Monday, 6/13/16, 5 days ago, disappointed… What’s wrong with my lips?

Hi! Unfortunately bruising is always a possibility when you do injections, no matter where the injection is. The lips are especially well supplied with blood vessels, so bruising there is particularly common. The good news is that this will go away and you will have many months to enjoy your new lips. Pineapple, arnica and bromelaine supplements may help speed up the process to some degree. As far as the lumps and bumps go, that is common in the short term and tends to go away with a little time. Try to massage the lips – that should help smooth them out.

Hope that helps!

Hello doctors! About three months ago I had Artefill removed from my lips that left me with rock hard scar tissue. Now my lips feel so hard and tight that I cant smile properly. Is this normal for my type of intervention? Also, the incision on my nottom lip is still a little bit raised. (Not sure if its hypertophic scar). How long does it takes for the internal scar tissue to soften? What should I do to fasten this process? Should I try steroids or 5FU injections? Please help!

Hi! I’m sorry to hear about what happened, but don’t worry! The scar tissue that you atalking about should not be very difficult to soften. Injections of Kenalog, combined with 5FU and possibly Dexamethasone will certainly help. Your doctor will determine exactly what he or she wants to inject when they evaluate your lips. Make sure that you go to an experienced injection specialist because too much steroids can create indentations.

Hope that helps!

I ran into someone’s shoulder while playing soccer and my nose is now crooked. Can this be fixed without surgery?

Non Surgical Rhinoplasty is a procedure that I popularized 13 years ago and still perform on a daily basis. It works really well for mild to moderate crooked noses. Pictures of your nose would help determine whether you would be a good candidate, but an in person consultation is the only way to know for sure. I like to use either Voluma or Radiesse for the procedure. It takes 5 to 15 minutes to perform, carries minimal risks if any and causes minimal pain. Results are visible immediately afterwards and last for up to a year and a half. There are also permanent option available, using Bellafill, but I recommend that people try the temporary fillers first.

The problem is that you are reporting trouble breathing through your nose. Non Surgical Rhinoplasty really can’t help with breathing difficulties. I often recommend trying steroid nasal spray as an easy method of improving nasal breathing before you go for surgery, but again, evaluation of what’s going on inside your nose is necessary.

Hope that helps!

What filler is best suited for a non surgical nose job and will I be able to get the result I want?

I am currently looking for a doctor to perform a non surgical nose job. I don’t know if I have a bump on my bridge or if my nose just appears that way because it is just flat. I also have the type of my nose hanging and is most noticeable when I smile. Will the fillers be able to correct these areas? Also, will placing fillers on the bridge of my nose make it narrower? I have attached my photos and two I found on the internet as samples of what I would like to achieve. Thank you.

Would a non surgical nose job be able to fix the flatness of the tip of my nose? If not, then what?

Hi, and thanks for your question. This is a common problem I see with my Non Surgical Nose Job patients. Your tip lacks a little definition and therefore looks a bit flat. The Non Surgical Nose Job procedure would absolutely correct this issue, giving you better definition from the front view as well as a straighter nose from the profile. I’ve done the procedure on hundreds of noses exactly like this. The results have been great and completely natural in appearance. I would suggest Voluma as a filler because it lasts for up to 2 years and is soft and natural looking. Correcting the tip well takes finesse and expertise. Be sure to consult with a physician who is very experienced in performing this specific procedure and ask to see their before and after pictures to make sure that their aesthetic taste is the same as yours. Board certification is less important than specific experience.

Hope that helps!

Is there any way to fix breathing problems without surgery?

Unfortunately, the answer is probably not. The Non Surgical Nose Job procedure is designed to correct cosmetic irregularities of the nose. The injections do not affect the nasal passages and cannot typically improve nasal breathing. I have seen a few patients who report slight improvement of their breathing after injection of the side of the nose, but this is pretty rare. I would consult with a qualified Ear Nose and Throat specialist to explore your options.

Hope that helps!

My nose is bent is there any way to correct my nose without surgery please?

Hi Muzammil, Yes, it is certainly possible to make your nose look straighter without surgery, but it is tricky because, like Dr. Naderi says, we don’t want to make your nose alot wider. From the one picture, it seems possible in your case, but you have to know that it will not make your nose smaller, only somewhat straighter. The procedure would involve filling the left top area of your nose and then maybe a bit in the middle right side. I would probably use Voluma. The results last a long time with this filler and it is reversible at any time.

Hope that helps!

I don’t have the money for nose surgery to get it reshaped, so I looked into other things. Nasofix was the top answer!

Hi and thanks for your question. Nasofix is not your answer. These devices are a scam and do not work. Your nose does not actually seem that long, but its tough to tell from the picture. I think that your best bet would be to speak to a physician experienced in surgical and non surgical rhinoplasty. They can give you an idea of what your options would be.

Hi and thanks for your question. I think that you are a good candidate for both procedures. The Non Surgical Nose Job would better define your tip and give you more projection to your nose. It would also lift the bridge of your nose and bring the different parts of your nose into better proportion. Augmenting your cheeks would lift the focal point of your face and make your eyes more prominent. These two procedures would be what I would start with for you.

Hope that helps!

Is it a good idea to get a non surgical nose job? And how much would it cost?

Hi and thanks for your question. The answer depends on your nose. Without pictures it is impossible to tell if you are a good candidate for the procedure. In general, Non Surgical Rhinoplasty is a procedure that I popularized 13 years ago and still perform on a daily basis. It is great at raising a low bridge or a droopy tip, camouflaging a small bump, defining a rounded tip, and correcting mild crookedness. There are several options of fillers. For a temporary effect of about 1 to 1.5 years I like to use Voluma. The result is smooth and natural looking and the filler is reversible with an enzyme injection if you don’t like the result (almost never happens). There is a longer lasting filler called Bellafill that I use with patients who have had the temporary procedure. Bellafill lasts for many years and in some patients is actually permanent.

Whether temporary or permanent, Non Surgical Rhinoplasty takes 5 to 15 minutes to perform, involves minimal pain, minimal risk, no downtime or swelling and you can see the results immediately after the procedure. For good candidates, it is a great alternative to surgery.

Hope that helps!

Non-surgical nostril/tip symmetry fix – does it work?

Hi, and thanks for your question. I have seen many cases of post surgical alar retraction like this in my office. I have had success correcting the issue, for the most part, with filler injection to lower the left nostril. The result is never perfect, but I can usually improve the symmetry. Correcting the tip asymmetry is also possible by putting a bit of filler into the right tip. However, this is a very high risk procedure. The blood flow to the skin of the ala and the tip is not that robust in general. After 2 surgeries it is even more tenuous. You have to make absolutely sure that whoever is performing a procedure like this is an expert at Non Surgical Rhinoplasty.

Hope that helps!

Would a non surgical nose job work for my nose? British, African ethnicity

Hi, and thanks for your question. Although I would need to see better profile pictures to say for sure, it seems like you would be a great candidate for the Non Surgical Nose Job procedure. The Non Surgical Nose Job is a 5 minute procedure using simple injections to raise the skin of your bridge and tip by a couple of millimeters and give you a straight nose with a higher bridge and a better defined tip. The procedure is safe, painless and there is no swelling or recovery period afterwards. I would recommend using Voluma as a filler because it lasts for about a year and a half and is reversible at any time. This is a tricky thing to do well and make sure that it looks natural, so I would suggest consulting with a doctor who is very experienced in this specific procedure. Ask to see before and afters to make sure that their aesthetic matches your own.

Hope that helps!

Any suggestions for straight upper lip while smiling?

Hi!

It’s tough to tell from the picture, but it seems that you are referring to the cupid’s bow triangle in the middle of the top lip. If so, then I would not recommend filling that in. That area is a natural part of the lip and when we try to fill it in with fillers it can look unnatural and unattractive. The best thing to do would be to get an in person consultation with an experienced lip injector. Then you can really explain your goals and they can help you achieve them if possible.

Hope that helps!

Is Bellafill dangerous? Is it successful as a long lasting filler?

I’ve been using Bellafill regularly for 10 years and have never seen a serious side effect. Bruising is possible with any injectable and mild swelling can happen for a day or so, but I have never seen anything worse than that. Bellafill does last a very long time and for that reason you should be careful to go to a practitioner who is very experienced and conservative in the use of the product. It takes 2 to 3 sessions to get the final result and I space these sessions 6 to 8 weeks apart. The material is soft and natural looking when injected properly. One option that some of my patients take advantage of is to use temporary fillers like Voluma as a trial run and then switch to Bellafill when they are sure that they will like the results. Voluma is easily reversible and lasts for about a year and a half.

Hope that helps!

What options do you suggest to best correct misplaced Voluma? What are the drawback to reversing with Hyaluronidase?

Hi, I’m sorry that your Voluma injections didn’t go as well as you’d like. It’s tough to tell from the pictures what would be the best way to improve your result. It is possible that a little filler in the tear troughs and the soft part of the cheeks would do the trick. It is also possible that bringing the Voluma down a bit with hyaluronidase would be a good idea. The most important thing to do at this point would be to find a very experienced Voluma and filler injector and seek their opinion. Hyaluronidase is safe and effective. I have not seen long term side effects and the only way it causes dents is if too much is injected and more filler dissolves than was intended. You can always inject a bit more filler to fill any indentation. It will not permanently damage your native hyaluronic acid.

Hope that helps!

Is my top lip over corrected on top?

At 7 days, you may still be experiencing some swelling, but don’t worry! If it doesn’t go down, your doctor can always inject with a little hyaluronidase enzyme and partially dissolve the Restylane. Make sure that your doc is experienced in the use of hyaluronidase. If he or she is not, you should find someone who is.

Hope that helps!

Botox Question: Recovery Time of Treatment?

This is a common question in our clinic. Botox is a really remarkable medication in that it does exactly what it is supposed to do and nothing more – weaken muscles. How much weakness depends directly on the dose you inject. It stays only in the place you inject it without migrating and it is gone in 3 months. There are no allergies, no reactions and the only side effects are due to incorrect dosage or placement. The only limitation I recommend after Botox treatment is to not get a massage where you place your face into a circular pillow for a few days. Its OK to lie down, touch your face and resume all activities after injection. Sleeping without a pillow is fine.

Is It Ok to Have Radiesse Nose Injection 5 Months After Restylane Nose Injection? Fly Immediately After Radiesse Nose Injection?

Injecting Radiesse after Restylane in a nose should not be a problem assuming, of course, that the procedure is performed by a skilled, conservative injector who has good experience injecting the nose. Non Surgical Rhinoplasty is very much of an advanced injection procedure with a unique set of risks, so choosing the right practitioner is really important. I have combined Radiesse and hyaluronic acid fillers (Restylane is an HA filler) frequently and have never had a problem. Of the approximately 4000 Non Surgical Rhinoplasty procedures that I have done in the last 13 years, I have used that combination with at least 500 patients. Regarding the safety of Radiesse in the nose, I have used that filler in about 2500 patients with great results. Complications were limited to bruising or a little redness. Both resolved quickly. I don’t think that Radiesse or any other temporary filler causes scarring under the skin. I have seen many patients for second and third Non Surgical Rhinopalsty procedures and the skin looked and felt perfectly natural.A long flight is ok, but I would refrain from taking aspirin or ibuprofen for 24 hours after the injection. I would also not work out for 24 hours. I would sleep on an extra pillow and restrict salt for a day to keep swelling to a minimum.

Who is a Good Candidate for ThermiVa?

All women 21 and over are good candidates for ThermiVA. It is completely non invasive and it doesn’t hurt at all, so there are not many limitations on who can get the procedure. We do not treat pregnant women, women that are menstruating and women who have had abnormal pap-smears. We would require a note from your doctor approving the treatment if any abnormalities were noted during your most recent GYN examination.

Successful removal of Artefill/Bellafill?

Its tough to answer your question completely without photos of the problem you are trying to correct. If you could post or send me these, I could give you a more precise answer. In general, if you could avoid surgical removal of artefill / bellafill, that would be optimal. Cutting the material out tends to be complicated and tends to leave scars. If your issue is bumps or contour irregularity of your nose, I would suggest steroid injection and / or injection of filler around the contour issue to try to camouflage it. I have managed this kind of issue before and the result has been excellent. Hope that helps and feel free to reach out with further questions.

ThermiVa: What is The Downtime?

What’s wonderful about ThermiVa is that there is no downtime. It is totally non-invasive and there is absolutely no pain. Anesthesia is never necessary. You can resume all activities right after, including sexual activity.

Can Botox in Masseter result in Paralysis, Anaphylaxis or Permanent Damage?

Hi and thanks for your question. The answer is no. Botox is extremely safe, and the injectors that are telling you so are not downplaying the risks, but telling it like it is. The nurse who says that it stays in the CNS does not know what she is talking about. It is not a virus, it is an extremely well researched medication. 1. Botox absolutely does not move around in the body or migrate in any way. It stays in the area injected, has no systemic effects and gets broken down in 3 months or so. It will not restrict the airway. 2. Anaphylaxis to Botox has never been reported. 3. The masseter treatment with Botox is safe, effective and easy. I have been performing it daily for 8 years with exactly zero major side effects.

Hope that helps!

What can I do to minimise my square jaw? Would Botox in the masseter benefit my face?

Hi and thanks for your question. You are the perfect candidate for masseter reduction with Botox. Chances are that you are either clenching or grinding your teeth at night and you may not even be aware of it. It is very common. The goal of this treatment is not to have you on Botox for the rest of your life, but to try to break the habit of grinding or clenching when you are stressed. I have been ding this for a decade now and I still see patients daily with bruxism (medical term for teeth grinding). The best results are when we can do 3 treatments, each being 3 months apart, and keep the muscles weak for an extended time. Many of my patients no longer require Botox treatment after that.

Hope that helps!

Nose tip brought in a bit?

Hi and thanks for your question. Yes, you could use a filler like Voluma or Radiesse to bring your tip down and lengthen it. This would make your nose more proportional to the rest of the face. Voluma lasts abotu 1.5 years in the nose and Radiesse lasts about 10 months. I would want to know if you have had surgery on your nose before. If you have, the procedure can still be performed but the injector has to be very careful of not injuring the skin. Non Surgical Rhinoplasty is a very advanced procedure. You should seek out an experienced injector.

Hope that helps!

Voluma in nose. It is bigger, round and bulkier. What can I do?

Hi and thanks for your question. Voluma is an excellent filler for Non Surgical Rhinoplasty, but you have to be careful to use it sparingly so as to avoid outcomes like this. Fortunately, Voluma is reversible with simple injections of hyaluronidase. It is easy to dissolve part or all of it. If your doc refuses to fix it, I would recommend that you go to someone very experienced in the procedure and it should be simple to correct. Your nose is quite nice. I perform this procedure daily with Voluma and I would think that you would have needed a very tiny amount to get a fantastic result.

Referral to doctor with expertise in Voluma cheek Injections in LA area?

Hi, thanks for your question. You are correct in your criteria. Experience and results are what matters. Specialty does not necessarily make a difference. I’ve taught good injectors of every specialty and a good number of nurses who were more talented than some of the doctors out there. We have been doing multiple Voluma Cheek Augmentations daily since the day Voluma was FDA approved in October 2013. I have personally performed over 1000 of these procedures. Voluma has become my favorite filler because it is soft, natural looking, long lasting (1.5 years) and reversible.

Hope that helps!

1ml Voluma in nose to reshape and Botox on tip to lift the nose, is that too much?

Hi, and thanks for your question. From the photos, you seem to be a good candidate for the Non Surgical Rhinoplasty procedure, but I would caution you not to expect perfect results. I think that, even in the most experienced hands, you may still have a bit of a curve to your nose. Botox is a good idea. When injected into the area below the tip it will lift your tip. The effect only lasts for 3 months, but it is worth it, considering you only need 3 to 4 units. A syringe of Voluma is alot of product for Non Surgical Rhinoplasty. If your doc is thinking that he is going to use the whole syringe in your nose, I would be concerned. I would recommend speaking to him or her to make sure that only enough is used to straighten your nose and the rest can be injected elsewhere.

Hope that helps!

Will non-surgical rhinoplasty w/ Restylane improve my nasal tip? I have a bulbous tip and want it to be more refined.

Hi and thanks for your question. From the pictures you provide, it looks like Non Surgical Rhinoplasty can be very effective in making your nasal tip look more defined and less rounded. I do not think that you need surgery. I refine the nasal tip using fillers several times per week and the results look great. I like to use Voluma or Radiesse instead of Restylane because each of these fililers lasts considerably longer than Restylane. But the most important thing is that non surgical tip refinement is a tricky procedure to perform, so you have to make sure that the person injecting is very experienced in this specific technique. The challenge is to refine the tip without making it look bigger and that takes some finesse. Make sure to review your injector’s before and after photos.

Hope that helps!

Nurse practitioner says adding more Juvederm through the tear trough could cause blindness?

Hi and thanks for your question. Tear trough injection is a very common and, in the right hands, a very safe procedure done all over the world. In my practice, we perform this procedure several times a day with fantastic results. It is one of my favorite treatments because the results are so dramatic and they last for several years. I like to use Juvederm that I modify specifically for the under eye area. I routinely promise people two years, but I have seen patients come back after five years and only need minor touch ups. Of course, since your nurse practitioner is uncomfortable doing this kind of injection you should find someone really experienced because it is an advanced injection procedure.

Hope that helps!

I was thinking about having non surgical rhinoplasty to amend the drooping nose tip I have! Any suggestions?

Hi and thanks for your question. From the photos, it looks like you would be an excellent candidate for the Non Surgical Nose Job procedure. It would involve a careful injection of fillers and a little Botox into the tip to lift it and give it nice definition. In my practice, I prefer to use Voluma or Radiesse for lifting the tip. Voluma will give the maximal duration of effect and Radiesse will give the maximal lift. Sometimes I will use the two in combination to get best of both effects. Lifting the tip non surgically is tricky, so be sure to find the person in your area most experienced with injecting the nose. Also, be sure to ask for before and after photos.

Hope that helps!

Juvederm injected in my nose, what are my options to reversing it? What are the side effect of having it dissolved?

Hi and thanks for your question. Reversing Juvederm 3 is actually quite easily done with an enzyme called hyaluronidase. It dissolves the filler, but does no harm to your tissues. If you are a week out from the procedure, I would wait another week and if the tip is still too rounded, go ahead and try to dissolve part of it. Juvederm 3 is not a great filler for this procedure. I would suggest a more robust one like Voluma and you have to make sure that your injector is very experienced in the procedure to ensure that you get the best results. Defining the tip, in particular, is tricky but looks great when done right.

Hope that helps!

Can I get a hooked nose without surgery?

Hi and thanks for your question. I can’t tell you for sure until I see photos, but it sounds like what you are describing can be corrected with Non Surgical Rhinoplasty. Adding enough filler to the bridge of the nose will make it look somewhat hooked. If done carefully it will look very natural. I have done this with several patients (as you can imagine, its not a common request) and the results have been great. I usually recommend starting with Voluma because it is soft and natural looking, lasts a long time and is reversible. Once the Voluma dissolves, in a year and a half, Bellafill is an option. That filler should last 5 to 10 years. What you are requesting is a tricky procedure, so make sure that you find an injector who is very experienced in this specific procedure.

Hope that helps!

How can i get rid of this bump on my nose without using plastic surgery?

Hi and thanks for your question. You have a small bump on your nose that is very simple to camouflage with the Non Surgical Nose Job procedure. You certainly do not need to have rhinoplasty surgery to make your nose straight. The Non Surgical Nose Job is a 5 minute procedure using simple injections to raise the skin above your bump by a couple of millimeters and give you a straight nose. The procedure is safe, painless and there is no swelling or recovery period afterwards. I would recommend using Voluma as a filler because it lasts for about a year and a half and is reversible at any time. Even though the filler would be adding to your nose, when we make your nose straight it will look smaller because it will blend in to the rest of your face. I would suggest consulting with a doctor who is very experienced in this specific procedure. Ask to see before and afters to make sure that their aesthetic matches your own.

Hope that helps!

I have a drooping nose. Is there anything I can do non surgically to fix it?

Hi Daniel and thanks for your question. From your pictures it looks like you would be a great candidate for the Non Surgical Nose Job (Non Surgical Rhinoplasty) procedure. I don’t think your nose is necessarily too big for your face. It just has a bit of a droop to the tip, which can easily be corrected with some filler. The interesting thing is that when your nose is straighter it will look smaller because it blends in to the rest of your face. For examples of this phenomenon, take a look at the before and after images on my website (link below). Fillers are a good option because you can start with a temporary, reversible correction that lasts for a year and a half with Voluma and then go to a permanent correction with Bellafill.

The procedure itself will take about 5 minutes. Risks are minimal and there is no downtime or pain afterwards. Although the procedure itself is fairly straightforward for you, making sure the result is perfectly natural and the tip of your nose does not get wider is tricky from the injector’s standpoint. The person doing the procedure has to be very experienced in the specifics Non Surgical Rhinoplasty. If you have any questions about the Non Surgical Nose Job, please feel free to call me anytime.

Hope that helps!

Asymmetry after Non Surgical Nose Job, can this be fixed?

Hi and thanks for your question. Be sure to raise your concerns with your injector and they should make you confident that they can correct the asymmetry and give you a straight nose. This procedure is supposed to make your nose look better not worse. If the filler is dissolved, your nose will not look worse. Molding will not have a permanent effect on the nasal tissues. Make sure that your injector is very experienced in specifically this procedure. If he or she is not, I would consider getting an opinion from someone who is. Non Surgical Rhinoplasty is a tricky procedure and small changes can have a significant effect on your appearance.

Hope that helps!

Only 1 syringe of juvederm injected just 2 days ago in lip. I have quite a bit of swelling & bruising, is this normal?

Hi, and thanks for your question. Unfortunately, swelling and bruising are relatively common after lip injection. The lips are a very vascularized area. What I can see in the pictures looks normal swelling and bruising, nothing more. Ice is certainly a good idea. I would also suggest taking some Arnica Montana pills and eating some pineapple. These both could help with bruising. For the swelling, I would suggest a low salt diet for a few days and sleeping with your head elevated on two pillows if possible. Also, don’t exercise for a few days. Take Tylenol for the pain, not aspirin or Ibuprofen. It is concerning that you can’t reach the spa. Any place you go should have some way of reaching them on the weekends.

Granulomas vs filler deposits – how to differentiate?

Hi Maggie and thanks for your question. I assume from your question that you had your neck injected for the horizontal necklace lines across the neck. These are notoriously difficult to inject without causing lumps. Over the years, I have seen that you need to use the softest filler possible to get a smooth result. Your lumps are extremely unlikely to be granulomas. They are collections of filler. You should try to massage them out if possible. See what your doctor recommends you do, but if you can’t get the lumps to go away, your doctor may have to dissolve them with hyaluronidase.

How exactly does Restylane and Juvederm work for acne scars?

Hi and thanks for your question. I would want to see you to be sure, but from what you write, it sounds like you would have the best results with a combination treatment of laser and fillers. Acne scars are tough to improve so you should use the most intense laser possible for your skin type. If you have light skin, I would recommend a CO2 laser or a Fraxel. Multiple sessions will be necessary with either device, but you will need less sessions with the CO2. Recovery time will be more with CO2. After you are done with the lasers, then you can try fillers for whatever contour irregularities you have left. Both temporary and permanent fillers work to improve acne scars. My suggestion would be to try the temporary fillers like Juvederm or Restylane first. Make sure that you choose a practitioner with lots of experience in multi-modality treatment of acne scars.

How long after a nose injury should I wait before getting a ‘non-surgical’ nose job for a VERY small bump that appeared on nose?

Hi, and thanks for your question. Camouflaging a small bump with filler is most certainly safe and effective. If you don’t have to get surgery, you should not get surgery. Likely complications in your case would be limited to a bruise. Waiting a few weeks after your injury would be wise. I think that, if your wedding schedule permits it, you should wait 4 weeks before you consider doing filler. I usually use Voluma for this kind of issue. It is smooth, results are natural looking and it is easily blended. Voluma should last about a year to a year and a half. Another advantage of Voluma is that it is easily dissolved, either partially or fully, with an enzyme called hyaluronidase. If, when the Voluma fades away the bump comes back, you can consider doing the same procedure with Bellafill, a more permanent filler that lasts upwards of five years.

Bellafill. Should I see a difference in a month?

Hi and thanks for your question. Bellafill (previously known as Artefill) is a filler that works a bit differently from the others we use. It contains 80% collagen and 20% methyl methacrylate, which is the permanent component. After it is injected, the collagen part is dissolved by your body and the methacrylate beads stimulate a collagen response over time that fills in the area where the collagen was. So, my recommendation is to wait another month or so to see your results. The collagen stimulation takes time.

Hope that helps!

My round face is bored me maybe chin fillers?

Hi and thanks for your question. It seems to me that you would be a good candidate for augmentation of the entire cheek area – the front or malar part and the side or zygomatic part. This would make the shape of your face more oval and would shift the focal point of your face up, emphasizing your eyes. I think that Voluma would be a good filler to accomplish this goal – it will give good structural support, look natural and it is reversible with enzyme injection. Voluma lasts about a year and a half. Masseter reduction would also help. Botox works very well for that. These procedures involve relatively advanced injection techniques. Be sure to consult an experienced injector and ask to see before and after pictures. Experience is more important than specialty or board certification.

Hope that helps!

What can I do to minimise my square jaw? Would Botox in the masseter benefit my face?

Hi and thanks for your question. You are the perfect candidate for masseter reduction with Botox. Chances are that you are either clenching or grinding your teeth at night and you may not even be aware of it. It is very common. The goal of this treatment is not to have you on Botox for the rest of your life, but to try to break the habit of grinding or clenching when you are stressed. I have been ding this for a decade now and I still see patients daily with bruxism (medical term for teeth grinding). The best results are when we can do 3 treatments, each being 3 months apart, and keep the muscles weak for an extended time. Many of my patients no longer require Botox treatment after that.

Hope that helps!

What is the safest way to enhance lips? I tried Juvederm Ultra in my top lip and had a bad reaction in my skin up to my nose.

Juvederm is a really great injectable for lip enhancement. I have had great results using this product over the last 13 years. However, lip injection is indeed an art form and it does take experience and a good eye to be sure that you have a good result. Allergic reactions to Juvederm are possible, but are really quite rare. I would want to get more information about your reaction to know for sure if you are allergic or if there was an issue with how it was injected.

How can I achieve a softer look to my face?

You look great and the biggest priority is that whatever injections or lasers that you do have to preserve that natural, beautiful look that you already have. So the name of the game is subtle. Fillers can be used to achieve most of what you want to do. Your jawline is well defined and smooth. Eliminating the little hollows next to your chin can be accomplished with a hyaluronic acid filler like Voluma or Restylane Lyft. Giving your nose a slimmer look can be done with fillers to blend the tip with the rest of the nose. It is possible to slim the tip with steroid injection in some patients, but its tough to tell if you are a good candidate for that. Subtle sculpting of your eyes could help make them look less sleepy.

I would encourage you to seek out a very experienced injector because what you are looking for is not so easy to accomplish. Hope that helps.

I ran into someone’s shoulder while playing soccer and my nose is now crooked. Can this be fixed without surgery

Non Surgical Rhinoplasty is a procedure that I popularized 13 years ago and still perform on a daily basis. It works really well for mild to moderate crooked noses. Pictures of your nose would help determine whether you would be a good candidate, but an in person consultation is the only way to know for sure. I like to use either Voluma or Radiesse for the procedure. It takes 5 to 15 minutes to perform, carries minimal risks if any and causes minimal pain. Results are visible immediately afterwards and last for up to a year and a half. There are also permanent option available, using Bellafill, but I recommend that people try the temporary fillers first.

The problem is that you are reporting trouble breathing through your nose. Non Surgical Rhinoplasty really can’t help with breathing difficulties. I often recommend trying steroid nasal spray as an easy method of improving nasal breathing before you go for surgery, but again, evaluation of what’s going on inside your nose is necessary.

Hope that helps!

Hollow eyes – what options do I have?

Hi, thanks for you question. Correcting tear trough (this is what we call the under eye area when we are talking about dark circles) volume loss with fillers is one of my procedures and one that I have been performing daily in my clinic for 12 years. I like it because it is painless, quick, involves minimal risk and patients look 10 years younger and much less tired in 5 to 15 minutes. I like to use Juvederm that is specially prepared for the tear trough area by my office staff according to my specifications. I have seen that prepared Juvederm lasts anywhere from 2 to 6 years in the tear trough, depending on the patient. It is also easily reversible with a simple injection of an enzyme.

Hope that helps!

Any suggestions for straight upper lip while smiling?

Hi

It’s tough to tell from the picture, but it seems that you are referring to the cupid’s bow triangle in the middle of the top lip. If so, then I would not recommend filling that in. That area is a natural part of the lip and when we try to fill it in with fillers it can look unnatural and unattractive. The best thing to do would be to get an in person consultation with an experienced lip injector. Then you can really explain your goals and they can help you achieve them if possible.

Hope that helps!

There is something asymmetric with my face. Minor details that I notice, what can be done to minimize the asymmetry?

Thanks for your question and your pictures. Firstly, no-one’s face is perfectly symmetric and if you really look at the faces of beauty icons such as Angelina Jolie and the like, you will notice that its the mild asymmetry that makes their faces so interesting to the eye. If they were perfectly symmetrical, their faces wouldn’t be nearly as captivating. So, you are in good company. That being said, from your pictures it looks like your left side has less volume than your right at the jaw and the right has less volume in the cheek. It should be no problem to add volume to both areas using injectable fillers like Voluma, Juvederm or Radiesse. Botox can reduce the chin a bit, but it may take some months to see results.

Hope that helps!

Can Botox in Masseter result in Paralysis, Anaphylaxis or Permanent Damage?

Hi and thanks for your question. The answer is no. Botox is extremely safe, and the injectors that are telling you so are not downplaying the risks, but telling it like it is. The nurse who says that it stays in the CNS does not know what she is talking about. It is not a virus, it is an extremely well researched medication. 1. Botox absolutely does not move around in the body or migrate in any way. It stays in the area injected, has no systemic effects and gets broken down in 3 months or so. It will not restrict the airway. 2. Anaphylaxis to Botox has never been reported. 3. The masseter treatment with Botox is safe, effective and easy. I have been performing it daily for 8 years with exactly zero major side effects. .

Hope that helps!

Would a non surgical nose job be able to fix the flatness of the tip of my nose? If not, then what?

Hi, and thanks for your question. This is a common problem I see with my Non Surgical Nose Job patients. Your tip lacks a little definition and therefore looks a bit flat. The Non Surgical Nose Job procedure would absolutely correct this issue, giving you better definition from the front view as well as a straighter nose from the profile. I’ve done the procedure on hundreds of noses exactly like this. The results have been great and completely natural in appearance. I would suggest Voluma as a filler because it lasts for up to 2 years and is soft and natural looking. Correcting the tip well takes finesse and expertise. Be sure to consult with a physician who is very experienced in performing this specific procedure and ask to see their before and after pictures to make sure that their aesthetic taste is the same as yours. Board certification is less important than specific experience. Hope that helps.

Which is better? The non-permanent fillers or the permanent fillers for non-surgical rhinoplasty?

Hi, and thanks for your question. The Non Surgical Nose Job procedure is very effective at correcting cosmetic nasal irregularities whether we use temporary fillers like Voluma or Radiesse or permanent fillers like Bellafill. I recommend using temporary fillers first and then switching over to Bellafill once the temporary fillers fade away. For Voluma, that takes about a year and a half and for Radiesse it takes about 10 months. Choosing the filler that is best for you will depend on what your nose looks like and what areas of the nose you are trying to correct. Non Surgical Nose Job is a tricky procedure to get just right, so be sure to go to an injector with significant experience for optimal results.

Hope that helps!

My nose is bent is there any way to correct my nose without surgery please?

Hi Muzammil, Yes, it is certainly possible to make your nose look straighter without surgery, but it is tricky because, like Dr. Naderi says, we don’t want to make your nose alot wider. From the one picture, it seems possible in your case, but you have to know that it will not make your nose smaller, only somewhat straighter. The procedure would involve filling the left top area of your nose and then maybe a bit in the middle right side. I would probably use Voluma. The results last a long time with this filler and it is reversible at any time.

Hope that helps!

There is something asymmetric with my face. Minor details that I notice, what can be done to minimize the asymmetry?

Thanks for your question and your pictures. Firstly, no-one’s face is perfectly symmetric and if you really look at the faces of beauty icons such as Angelina Jolie and the like, you will notice that its the mild asymmetry that makes their faces so interesting to the eye. If they were perfectly symmetrical, their faces wouldn’t be nearly as captivating. So, you are in good company. That being said, from your pictures it looks like your left side has less volume than your right at the jaw and the right has less volume in the cheek. It should be no problem to add volume to both areas using injectable fillers like Voluma, Juvederm or Radiesse. Botox can reduce the chin a bit, but it may take some months to see results.

Hi! As we age, the distance between the nose and the top of the cupid’s bow increases. It is rarely caused by fillers and is certainly not a result of prolonged use of injectables in the upper lip, so don’t worry about that. If anything, use of fillers in the upper lip will encourage collagen growth which should help the lip resist drooping. The collagen will also help prevent those tiny wrinkles from forming.

Hope that helps!

Young with dark circles/bags under eyes. Could someone please tell me the cause and any treatments for it?

Hi and thanks for your question. You have a genetic propensity for tear trough hollows. The hollows produce a shadow that falls into the groove and give the appearance of dark circles, which makes you look ill or tired. This is easily corrected with filler injection. I take Juvederm and prepare it specifically for injection into the under eye area. This preparation is soft and natural looking and gives patients 2 to 6 years of duration. Most importantly, it is easily dissolved with enzyme. In my office, this is a two stage procedure, with a touch up visit 2 to 3 weeks after the initial one. Feel free to take a look at the before and after pictures on the website.

Hope that helps!

Would a non surgical nose job be able to fix the flatness of the tip of my nose? If not, then what?

Hi, and thanks for your question. This is a common problem I see with my Non Surgical Nose Job patients. Your tip lacks a little definition and therefore looks a bit flat. The Non Surgical Nose Job procedure would absolutely correct this issue, giving you better definition from the front view as well as a straighter nose from the profile. I’ve done the procedure on hundreds of noses exactly like this. The results have been great and completely natural in appearance. I would suggest Voluma as a filler because it lasts for up to 2 years and is soft and natural looking. Correcting the tip well takes finesse and expertise. Be sure to consult with a physician who is very experienced in performing this specific procedure and ask to see their before and after pictures to make sure that their aesthetic taste is the same as yours. Board certification is less important than specific experience. .

Hope that helps!

How can I make my Juvederm cheek injections last longer? Will they last longer the more I get them done?

Hi, and thanks for your question. I use Voluma daily in the cheeks and I’ve found it to be a really good, long lasting filler. In my experience, Voluma should last 1 to 1.5 years. Two syringes is a good amount of Voluma for someone as young as you and, even though there is some variability in how long any filler lasts, it would be really unusual for the Voluma to not be there after a month. Sometimes we get used to looking good, so I would suggest comparing before and after images at your injector’s office to see if you can see the difference. Make sure that your injector is very experienced in Voluma injection – it takes experience to get facial sculpting just right.

Eye bags and wrinkles developed rapidly within last 3-4 months. What is going on?

From the pictures, it looks like you are seeing normal signs of mild aging. Don’t worry! There’s lots of stuff that can be done to improve things. It sounds like you are doing some of the right things by drinking lots of water and using retinol. I don’t know what this venom stuff is, but just make sure its not something harmful. It looks like you need some relatively simple, non surgical procedures to camouflage the eye bags and get rid of the wrinkles. Botox will help with the wrinkles. The under eye area will improve dramatically with injection of some hyaluronic acid filler. I use Juvederm that I specifically prepare for the under eye area. The results over the last 12 years and thousands of patients have been really great. Duration of effect is fantastic under the eyes as well. I have had patients come back after 6 years and they don’t need a touch up! I would think twice about the local medi spa, however. The under eye area is tricky to inject well. I would find an experienced injector, preferably referred by someone you trust, who can show you lots of before and after pictures. When it comes to your face, there are no short cuts. Do your research and you will have beautiful, long lasting results.

Hope that helps!

Can lumpy, uneven Restylane injections on my cheekbones be fixed or should they be dissolved? Do I need a better doctor?

Hi and thanks for your question. I can see what you are talking about, unfortunately. I agree with the other doctors posting here. You should seek another opinion. Cheek augmentation can be a really great procedure with smooth, natural results that last a long time. Years ago, Restylane was the only filler we had, so people would use it everywhere. Today we have a much better option for the cheeks with Voluma. It is a smooth filler that produces natural results that last for a year and a half or more. I would suggest you consult with an experienced injector where the main focus of their practice is non surgical aesthetics as opposed to someone who just does injections as a side activity to their surgical practice.

Hope that helps!

Which is better? The non-permanent fillers or the permanent fillers for non-surgical rhinoplasty?

Hi, and thanks for your question. The Non Surgical Nose Job procedure is very effective at correcting cosmetic nasal irregularities whether we use temporary fillers like Voluma or Radiesse or permanent fillers like Bellafill. I recommend using temporary fillers first and then switching over to Bellafill once the temporary fillers fade away. For Voluma, that takes about a year and a half and for Radiesse it takes about 10 months. Choosing the filler that is best for you will depend on what your nose looks like and what areas of the nose you are trying to correct. Non Surgical Nose Job is a tricky procedure to get just right, so be sure to go to an injector with significant experience for optimal results.

Hope that helps!

Are these considered eye bags, dark circles or puffy eyes? And what can I do about them?

Hi, and thanks for your question. From the picture, it looks like you have a bit of fullness to your lower eyelid from a little fat protrusion. You also have a little volume loss under the lid, otherwise known as tear trough hollows. The hollow results in a shadow falling into the area and the appearance of dark circles under the eyes. This combination of events (fullness and volume loss) happens to everyone sooner or later, depending on genetics. I correct this issue daily in my clinic using a form of Juvederm I prepare specifically for the under eye area. The Juvederm fills the hollow and camouflages the lower lid fullness. Using this preparation, I have seen results last for up to 6 years. Some patients need a touch up earlier, but I can promise at least 2 years. The procedure is safe, takes 15 minutes to perform and results are visible immediately after. Of the 4000 of these I have done over the past 12 years, the worst side effect I have seen is a temporary bruise. .

Hope that helps!

Can a nose be made thinner/more defined with Botox and fillers only?

Hi and thanks for your question. I think that you are actually a good candidate for Non Surgical Rhinoplasty. Adding some filler (I prefer Voluma here – it lasts for a year and a half, looks natural and is reversible at any time) to the bridge will define it better, make your nose look more narrow and give better proportion to your nose. The narrowing of your nose is an illusion, based on the fact that the eye judges the width of something from the top layer. If you put a narrow top layer to your bridge, the whole nose will look more narrow. It has to be done carefully, however, to make sure that your bridge does not come up too high on the profile. You should make sure that, if you go with this option, you choose a very experienced injector. Your weight should not affect the width of your nose.

Hope that helps!

Is Bellafill dangerous? Is it successful as a long lasting filler? (photos)

Is bellafill dangerous? I’ve heard all kinds of claims from it causing cancer to horror stories I just want a light plump in volume in my flat cheekbones. I feel it would also pull on the area around my mouth which also bothers me as I appear to have nasolabial lines but filler in my cheeks I feel would pull and smooth those out as well. I want something long lasting that I don’t have to refill every 2 months. Would you suggest bellafill? If not what’s a good long lasting filler for my cheeks.

I’ve been noticing a similar look in a lot of women that get lip augmentations. It looks like the upper lip droops further from the nose (from the middle/tip of the nose, to top of cupids bow). Is this a side effect of prolonged use of injectables (especially in older women)? I’m 35 and have never gotten fillers in my lips, but am considering it for minor maintenance (tiny wrinkles etc), but I am afraid I will get the long upper lip.

Under my eyes it looks hollow I have lost weight what can I do. (photos)

Hi and thanks for your question. It looks like you have lost some volume in your face after losing weight. This is quite common and easily corrected non surgically, using fillers like Voluma and Juvederm. When correcting under eye volume loss, I use a modified version of Juvederm that we prepare in our clinic and I have seen the results last for 6 years (average of about 3 years, but reversible at any time with enzyme). After 12 years of filling the under eye area, the results I get with modified Juvederm are much better than results I was getting for Restylane. For the cheek area I would recommend Voluma. It is a soft, reversible filler that lasts a year and a half or more.

Hope that helps!

Can lumpy, uneven Restylane injections on my cheekbones be fixed or should they be dissolved? Do I need a better doctor? (Photo)

Last month a plastic surgeon injected Restylane high on my cheekbone, under the outer corners of my eyes. The results are uneven and lumpy, especially just under the eyes. The Dr said that the lumps were probably caused by fat. But the cheeks were smooth before he injected me. He recommended adding more Restylane. Should I get the filler dissolved or can it be salvaged? I saved for a long time to have this done & want it to work out. Should I risk returning to this doctor or find someone else?

Successful removal of Artefill/Bellafill?

Its tough to answer your question completely without photos of the problem you are trying to correct. If you could post or send me these, I could give you a more precise answer. In general, if you could avoid surgical removal of artefill / bellafill, that would be optimal. Cutting the material out tends to be complicated and tends to leave scars. If your issue is bumps or contour irregularity of your nose, I would suggest steroid injection and / or injection of filler around the contour issue to try to camouflage it. I have managed this kind of issue before and the result has been excellent. Hope that helps and feel free to reach out with further questions.

ThermiVa: How Many Treatments Will I Need?

Hi, and thanks for your question. ThermiVa works very well and results last about one year. For the best outcome, we recommend having three treatments, one month apart for each. The treatments are very easy. We have never had a patient experience any pain at all. It just feels warm. After the year is up, we recommend having 1 – 2 treatments per year in order to maintain results. We have been pleasantly surprised by how consistently women love this treatment and how frequently they refer their friends.

Hope that helps!

Which is better? The non-permanent fillers or the permanent fillers for non-surgical rhinoplasty?

Hi, and thanks for your question. The Non Surgical Nose Job procedure is very effective at correcting cosmetic nasal irregularities whether we use temporary fillers like Voluma or Radiesse or permanent fillers like Bellafill. I recommend using temporary fillers first and then switching over to Bellafill once the temporary fillers fade away. For Voluma, that takes about a year and a half and for Radiesse it takes about 10 months. Choosing the filler that is best for you will depend on what your nose looks like and what areas of the nose you are trying to correct. Non Surgical Nose Job is a tricky procedure to get just right, so be sure to go to an injector with significant experience for optimal results.

Hope that helps!

I had fillers voluma/restlyane about a mouth ago..if I do a vampire facial will that dilute or breakdown my fillers?

Hi and thanks for your question. Doing a Vampire Facial or Facelift should not dilute or breakdown any previous filler work. If anything, it will stimulate collagen and enhance your look even more. Vampire procedures are actually nicely synergistic with fillers because they correct the texture of the skin while the fillers correct underlying structural and volume loss. Vampire facials help in decreasing pore size, smoothing out acne scars, and diminishing the appearance of fine lines. Since this is a superficial treatment, it will not interact with any filler.

Hope that helps!

Is there any way I can get rid of my under eye bags non surgically? (Photo)

It’s tough to say from the picture, but maybe. We would have to fill in the tear trough area underneath the fullness in your lower lids. Most likely, filler (I like to use Juvederm that I prepare specifically for tear trough injections) can make the area look better, but not flawless. It is possible that your fullness cannot be camouflaged effectively without surgery and you will have to get a fat repositioning procedure for your lower eyelids. I would suggest consultation with a very experienced injector in your area as well as an oculoplastic surgeon.

Hope that helps!

I recently got PRP treatment for acne scars. Are PRP facelifts permanent or is it like thread lift??

Hi Raja, Thanks for your question. PRP (platelet rich plasma) treatments are different from thread lifts. The two procedures have different goals. Whereas thread lifts are temporary (about 6 months) procedures designed to lift skin and tissue, PRP improves the quality and texture of the skin for a long time. PRP involves drawing some of your own blood, spinning it down and extracting the part that contains growth factors and nutrients. Then we use a microneedling device to go over your skin and create thousands of little channels in your skin. We then put some of the PRP extract on your skin topically and inject the rest under the skin. The growth factors and nutrients make the skin more smooth and also add some volume. The procedure is very safe since we are using your own blood.

Hope that helps!

2 ml Voluma, 9 rounds of Vitrase. Doctor does not remember where injected or it migrated. MRI/detailed ct scan to find it?

I’m sorry, it sounds like you are going through a frustrating experience. I have managed a few cases where Voluma results in swelling and even intermittent, recurrent infection. This kind of thing might be happening with you. It is not easy to get the filler to dissolve in these cases. My suggestion would be to go to the most experienced Voluma injector you can find and see what they can do. Treatment may involve antibiotics and high doses of enzyme – much higher doses than usually employed to dissolve these kinds of fillers. Good luck and I’m happy to chat with you in detail if you’d like to call for advice.

Hope that helps

What’s wrong with my lips? (Photo)

Hi!

Unfortunately bruising is always a possibility when you do injections, no matter where the injection is. The lips are especially well supplied with blood vessels, so bruising there is particularly common. The good news is that this will go away and you will have many months to enjoy your new lips. Pineapple, arnica and bromelaine supplements may help speed up the process to some degree. As far as the lumps and bumps go, that is common in the short term and tends to go away with a little time. Try to massage the lips – that should help smooth them out. Hope that helps!

Hard scar tissue after Artefill removal. Any suggestions?

Hi!

I’m sorry to hear about what happened, but don’t worry! The scar tissue that you atalking about should not be very difficult to soften. Injections of Kenalog, combined with 5FU and possibly Dexamethasone will certainly help. Your doctor will determine exactly what he or she wants to inject when they evaluate your lips. Make sure that you go to an experienced injection specialist because too much steroids can create indentations. Hope that helps!

How can I achieve a softer look to my face? (photos)

Hi!

You look great and the biggest priority is that whatever injections or lasers that you do have to preserve that natural, beautiful look that you already have. So the name of the game is subtle. Fillers can be used to achieve most of what you want to do. Your jawline is well defined and smooth. Eliminating the little hollows next to your chin can be accomplished with a hyaluronic acid filler like Voluma or Restylane Lyft. Giving your nose a slimmer look can be done with fillers to blend the tip with the rest of the nose. It is possible to slim the tip with steroid injection in some patients, but its tough to tell if you are a good candidate for that. Subtle sculpting of your eyes could help make them look less sleepy.

I would encourage you to seek out a very experienced injector because what you are looking for is not so easy to accomplish.

Hope that helps.

Authenticity of Botox administered six months ago on 6 January 2016. What to do if the office doesn’t keep and provide a record?

Its a reasonable question, but I think that there are not many offices who chart the vial / lot number of the Botox they use. We do not routinely do so. Botox is so reliable that I have not seen an adverse event that can be attributable to the medication in 13 years of practice. If you are concerned about how long it is lasting you should chat with the office – usually that is an issue of dosage rather than bad Botox. I agree with the previous responses – you can always call Allergan to make sure the doctor is purchasing from them. In the office, you can ask to see the bottle. Allergan Botox has a distinctive hologram that is difficult to counterfeit. Most importantly choose your injector wisely – go for reputation and recommended injector over price.

Which One is Better Botox or Fillers?

Botox can be used in many areas of the face to relax the targeted muscle, and soften the wrinkle or “line”. In some cases, such as deep forehead lines or deep glabellar lines, Botox and filler can be used in combination to get rid of the line completely. For smile lines around the mouth, a hyaluronic acid filler works well to fill in the area and get rid of the line. Smile lines around the eyes respond well to injections of Botox. Botox lasts 3-4 months. The duration of fillers depends on the specific filler used. They can range from 8 months to 2 years. There is also a permanent filler called Bellafill.

Side effects are uncommon with both Botox and fillers. Botox has been extensively studied for over two decades and has been judged to be one of the safest medications ever used. The fillers are made from materials like hyaluronic acid and calcium which are already in your body, so reactions are extremely rare. This being said, it is important to choose an experienced and qualified injector. Side effects can happen if these injectables are used incorrectly. Each company produces good products. Your doctor or nurse will determine which filler or toxin is best for you and give you options. Hope that helps!

Hollow eyes – what options do I have?

Hi, thanks for you question. Correcting tear trough (this is what we call the under eye area when we are talking about dark circles) volume loss with fillers is one of my procedures and one that I have been performing daily in my clinic for 12 years. I like it because it is painless, quick, involves minimal risk and patients look 10 years younger and much less tired in 5 to 15 minutes. I like to use Juvederm that is specially prepared for the tear trough area by my office staff according to my specifications. I have seen that prepared Juvederm lasts anywhere from 2 to 6 years in the tear trough, depending on the patient. It is also easily reversible with a simple injection of an enzyme.

Hope that helps

Can Kybella be used in the lower ankle area, more around the foot? (Photo)

If I understand your question correctly, you are not asking for reduction of your cankles, just the fat pocket in that area. This, of course, would be an off label use of Kybella, but we are actively exploring off label uses of Kybella in multiple clinics throughout the country. We have never injected Kybella into this area, but I do not see that it would pose an inherent danger. You would experience swelling after injection. Since it is an unexplored area of injection we don’t know how much, so conservative injection amounts would be necessary. So, I think that this could be an area where Kybella could help, but make sure to go to an extremely experienced Kybella injector and make sure that you guys go slow and conservatively.

I was wondering if there was any way to get rid of the small bump on my nose without plastic surgery? (Photo)

Non Surgical Rhinoplasty is a procedure that I popularized 13 years ago and still perform on a daily basis. I see excellent results camouflaging small bumps such as the one that you have. All it takes is a small amount of filler above and below the bump and your nose will be straight on profile. There are several options of fillers. For a temporary effect of about 1 to 1.5 years I like to use Voluma. The result is smooth and natural looking and the filler is reversible with an enzyme injection if you don’t like the result (almost never happens). There is a longer lasting filler called Bellafill that I use with patients who have had the temporary procedure. Bellafill lasts for many years and in some patients is actually permanent.

Whether temporary or permanent, Non Surgical Rhinoplasty takes 5 to 15 minutes to perform, involves minimal pain, minimal risk, no downtime or swelling and you can see the results immediately after the procedure. I think that it would absolutely be a great alternative to surgery in your case.

Hope that helps!

I’m not happy with the shape of my lips. What’s my best option? (Photo)

Lip Augmentation is a great way to enhance or correct your own lip shape while keeping a natural appearance. This can be achieved through filler injections without any need for surgery. The most preferred filler for the lips is Juvederm Ultra, which is a hyaluronic acid (a water binder found naturally in the body). Juvederm Ultra lasts anywhere from 6 to 12 months. The most common side effects for Lip Augmentations are bruising and mild swelling.

We recommend avoiding blood thinners (aspirin, ibuprofen, alcohol, fish oil etc.) for at least seven days before the procedure to help minimize your change of bruising. If pain is a concern, a topical numbing cream can be administered prior to injection to help manage any discomfort. Prices for Lip Augmentation vary between offices but a typical range can be anywhere from $400-$800 depending how much filler needs to be used. It is always recommended to do your research on providers in your area specializing in this treatment to make sure your in the best hands possible.